Some Heart Patients Better Off Without Stents
October 15th, 2008 laurie
Two new studies suggest that heart patients may be better off receiving fewer artery-opening stents. The devices too often are used indiscriminately, research shows.
The Wall Street Journal reports that these results from a study known as FAME were presented here at the annual Transcatheter Cardiovascular Therapeutics meeting of cardiologists and medical-device manufacturers. And those findings came the same day that an article in the Journal of the American Medical Association reported that, outside of emergencies, most stents are implanted too hastily in the U.S., without a medical test to verify the procedure was needed.
The FAME study suggests that doctors should go beyond the X-ray and measure the blood flow in each artery before implanting a stent. By only stenting arteries that are really choked off, the study suggests doctors could reduce subsequent deaths and heart attacks. In the study, doctors assigned half of the patients to conventional treatment using stents — guided by an X-ray alone. Those patients received 2.7 stents each on average. The other half had their blood flow in each major artery measured with Radi’s equipment. Only truly choked-off arteries were stented, and the patients received only 1.9 stents on average.
Several other cardiologists called the results instructive and predicted they may influence doctors to use stents more carefully. “The message is not, “Don’t stent things,’” said Ajay Kirtane, a cardiologist at Columbia University. “It’s, “Stent the right thing,’” he said.
